Automated detection and classification of corneal haze using optical coherence tomography in patients with keratoconus after cross-linking

Abstract

Purpose: To evaluate a proposed technology for offering objective grading and mapping of corneal haze as detected by corneal spectral domain optical coherence tomography after corneal cross-linking. Methods: This was a retrospective study to evaluate corneal optical coherence tomography images performed on 44 eyes of 44 patients who underwent corneal cross-linking between January 2014 and May 2015, at the American University of Beirut Medical Center. Results: Overall average brightness of the cornea was markedly increased from 43.4% (66.0) at baseline to 50.2% (64.4) at 1 month, 47.9% (64.4) at 3 months, and 46.4% (65.7) at 6 months with P,0.001,,0.001, and 0.005, respectively. In the anterior stroma, the average brightness significantly increased at 1, 3, and 6 months with values of 54.8% (63.9), 52.5% (65.2), and 49.7% (66.9) with P,0.001,,0.001, and 0.003, respectively. In the mid stroma, the change was clinically significant at 1 and 3 months, whereas in the posterior stroma, it was only significant at 1 month compared with baseline (P = 0.003). Overall, haze was mostly present at 1 month after surgery in all regions, especially in the anterior (32.1%; 619.2) and mid stromal regions (9.1%; 618.8), P,0.001 and 0.001, respectively. In contrast, haze in the posterior stromal region peaks at 3 and 6 months after surgery. Conclusions: Anterior stromal haze was the greatest in intensity and area and it was present for a longer time span than mid and posterior stromal haze. At 12 months, the anterior stroma had still more haze intensity than preoperatively. This image-based software can provide objective and valuable quantitative measurements of corneal haze, which may impact clinical decision-making after different corneal surgeries. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.